Individual provider Active NPI

Paul Zavala, O.T.

  • Occupational Therapist
  • Fort Myers, FL
National Provider Identifier
1235184698
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT9990 Issued in FL
Practice address
12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370
Phone
(239) 482-2663
Fax
(239) 482-7585
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT9990 FL Primary

Addresses

Primary practice location

12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370

Mailing address

12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370
Phone (239) 482-2663

Other practice location 1

8831 Founders Square Dr Fl 1
Naples, FL 34120-0733
Phone (239) 482-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110713000856 FL Practitioner - Occupational Therapist in Private Practice 2163690371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT9990FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Radiology Consultants P a Past Accepting new patients
Fyzbiz, LLC Past Accepting new patients
Orthopedic Center of Florida, Inc PastSince Jan 8, 2023 Accepting new patients
Medical & Sports Rehabilitation Center Inc Occupational Therapist Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6140/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1235184698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8831 Founders Square Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341200733",
            "country_code": "US",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAVALA",
        "first_name": "PAUL",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT9990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.